Over my Dad body!!

Some of my more astute followers may have noticed... aww who am I kidding? All of my followers are astute! So, all of you may have noticed that I have been missing from twitter lately. I tried to sneak a tweet in now and then but mostly I've been absent. The reason for my absence is that my wife has gone back to work after a little over a year off, most of which was with our baby girl. Here she is being choked by an RT.

So, in the classic role of Father/Provider I continued to work as much as possible to allow my wife to stay at home. My wife has never really worked as a nurse. She did some part time med passing at a NH as an LPN during school. So, naturally she was nervous about stepping out into nursing for the first time. I, on the other hand, was petrified about the idea of being alone to care for our infant daughter without anyone else around to help. So, lately, (If you can excuse my country colloquialism) I've been busier than a one-legged cat trying to bury a turd on a frozen pond. I don't mean to ignore twitter, but most of the time spent between witty posts/rejoinders before was spent at work which is my best Muse. Now that my wife is back to work I'm down to 3 days a week instead of 5-6. In addition to the new responsibility, it seems that more and more there is an ever increasing number of Nursing Anon accounts out there and they aren't coming up with much that is original. They may think they are, but they aren't.  I've started to have some of my older tweets stolen and my account copied and now my Avi is being used. I'm ready to evolve into something greater andI  have that in the works.  

It is no secret that I am a founding member of the @MurseMafia. We, as an organization, are planning to help change (or at the very least improve) nursing. Especially for men.  We are in the early stages of development now and are trying to earn enough capital to take off. We have a website, and we are selling merchandise for which we earn very little profit but each T-shirt or coffee mug we sell is advertising gold.  So, please make your way over to our store and take a gander at our inventory. I know the shirts are expensive but there are stickers and buttons that are pretty cheap. I'm networking right now with a freelance artist who creates designs and I'm hoping to get him on board for some new tshirts that we can ship ourselves 

We have big plans in store for our little project and I am excited about its future. If any of you have an over abundance of money and feel the need to donate email me and I'll let you know how. Otherwise, go buy some Murse mafia merch and we can all benefit. 

-@MurseWisdom

Does Nursing make me a better father?

Seven months ago, give or take a few days, my wife and I became members of a not-so-exclusive club referred to as Parenthood.  We did so willingly and, contrary to common practice for our area, we did it after we were married instead of getting married because we were pregnant. This is a meaningful distinction for us and it speaks volumes.  It says that we made this decision as two adults and were prepared for the consequences.

CONSEQUENCES shown below:

 
 

 

 Not bad for my first try. Wait until I get some more practice.

{Quick background on my wife because I'm pretty sure I've never really mentioned much about her. We met while taking pre-reqs for Nursing school but we had both went to high school together. I started Nursing school a semester ahead of her at the same school. Which led to a very rocky first few years of our relationship. However, we saved a bundle on books, or at least she did. We married in nursing school and she spent her last semester pregnant. Now back to the story.}

I started thinking soon after we found out we were expecting our little bundle of joy (see above) and aided in this thinking by current parents who relish the opportunity to tell you the hardships. Some of the more common things were as follows:

1. You would no longer sleep-in and possibly may never sleep more than a few hours at a time.
2. The amount of stress you will encounter is unlike anything you have ever felt before.
3. All the crying.
4. All the pooping.
5. All the diaper changes.

But then after the horror stories they would a the caveat... but it is SO worth it!

I made the correlation immediately!  I flashed back to my first year or maybe even first week in nursing school. When all of the seniors would see us and tell us of the horrors that awaited. Such as:

1. You would no longer sleep-in and possibly may never sleep more than a few hours at a time.
2. The amount of stress you will encounter is unlike anything you have ever felt before.
3. All the crying.
4. All the pooping.
5. All the diaper changes.

  Look familiar? My wife and I agreed that if we could both survive nursing school, at the same time no less, that this baby business would be a breeze. So, we went in to the final stages with very little stress about the imminent changes.

We discovered that raising a child is more difficult than nursing school in many ways, but it is also easier in many ways. 

Here is what I know, I know that my ability to function on 3 hours of sleep is legendary, and a newborn sleeps approx 20 hours a day. Unfortunately, my newborn did this sleeping 15 min at a time for the first 2 months. 

Baby: 1 Nurse Parents: 0

Despite a near disaster in the sleep department, I had developed the ability to perform everyday tasks without sleep. This is where performance enhancing drugs came into play. I'm not talking about anything illegal like cocaine, hell, I'm not even talking about Adderall these youngsters depend on to tie their damn shoelaces now-a-days. I'm talking about Caffeine. The real Vitamin C... I'm talking Monster, Coffee, Espresso,  Red Bull... you get the picture. I drank so much coffee the first week I gave myself an ulcer.  

Baby: 1 Nurse Parents: 1

Diapers? Seriously? I can change these little things with just my non-dominant hand while peering out of one bloodshot eye! I don't even need to go into the diaper thing.

Baby: 1 Nurse Parents: 2

Poop goes hand in hand with the diapers thing but I felt I should address it separately.  My baby didn't poop much the first month and a half. While at first this seems like a blessing, to a nurse is spells certain ileus! There was about 50 hours of research done in my household before finally asking a Dr. about this "Condition". We were given specific orders and followed them precisely. Every 5 days we produced a BM. It was nerve racking. 

Both sides get a point. Baby: 2 Nurse Parents: 3

Crying. I didn't cry in Nursing school because I am a Man and we have rules. Don't roll your eyes at me and say "Real men do cry" Because I will tell you that I am not imaginary and am very real, and I DO NOT CRY. However, my baby does, frequently, and I am told she gets it from me. I consider that to be a great injustice and resent even the slightest of comparisons. Regardless, crying is noise, and I can tune out noise.

Baby: 2 Nurse Parents: 4  

This brings me to stress.  There is no comparing the two events and the stress each one creates on its own massive level.  I will say this. When you leave Nursing school and go home, even if you have homework, you are still away from Nursing school. With babies, you are stressed all the time and coming home provides no refuge from the stress. Not even mentioning that Nursing school even if taken to its most extreme wouldn't even make it to puberty in the lifespan of a child.

Baby 3...  You know what, I'm sick of keeping score.  Nursing school is hard. Raising children is hard. Doing both is unimaginable, and yet I was in school with new mothers, old mothers, and single mothers.  My hat is off to you, ladies. I am in no way equipped to take that on. 

This Parenting thing is just starting and I'm sure will evolve from here as will my perspective on this whole thing.  Am I a better father because I'm a Nurse? Absolutely! Is the inverse true? Am I a better Nurse because I'm a father? I'd like to think that it adds a level of empathy. So, yes I am.

Well, I hear my little one starting to cry now. 

Thanks for reading,

MurseWisdom

Check out

www.MurseMafia.com
                and
www.NurseStrong.org

Night and Day

 You've heard that old colloquialism "as different as night and day". Recently I began to believe that this may not be referring to presence or absence of the sun and more appropriately, at least for nurses, as the differences between our counterparts on the opposite shifts.  This has always been an issue I would assume. I have noticed long ago that a certain animosity exists between most shift workers. I feel like I'm just stating the obvious here and that you guys will read this and roll your eyes as if I've been naive up until now. The truth is I'm just now reaching the point where I want to vent about it in a public way.

Let me put a little disclaimer on this. I will be speaking in generalities about hospitals and RNs/CNAs of opposite shifts. It goes without saying that this is about my situation at my hospital and does not reflect the work and professionalism of all nurses at my hospital or in the profession at large.

I work day shift now. I have worked night shift, so you can't pull the wool over my eyes about how "Hard" night shift is. I'm going to be blunt... Night shift is easier in general. Night shift is where we start our new nurses and it's where we keep the ones that are a little bit off. Sometimes a nurse will stay on nights because it's all they've ever done and their sanity surely depends on keeping their circadian rhythm on track. On night shift you have the luxury of not having admin looming around. You don't have to deal with meals, and you have a lot less family hanging around. For the most part, your patients sleep at night. Of course there are exceptions, sun downers being the most obvious. The bulk of medications are given during the day too. At my hospital, which is not a teaching hospital, we do not have doctors around after 5ish with the exception of the OB if delivering, the ER and emergency surgeries. Rounds are done (primarily) between 7 and 9am the exception being new admits who come up after rounds. So, night shift will hardly ever have to interact with a doc in person. Some of our night nurses admit to not even knowing what some of our docs look like. We don't have a unit secretary, at least not the conventional kind. We have a CNA who sits and goes over IV charting and charges for half a shift. We, as day nurses, are responsible for all the orders the providers spew out during rounds. With all of the discharges occurring between the hours of 8 and 5 there are only a couple of night nurses that can even complete a discharge, including house supervisors.

Now for the venting.

On an almost daily basis, I walk in to find night shift sitting and shopping online or watching TV on their phones or some other kind of shenanigans, with food and drinks scattered about. I am then privileged with a half-ass, substandard report on Pts that, if I had worked the day before, sounds almost exactly like the report I gave them, as if they were reading mine back to me. After they leave, I must scour the patients charts to determine what was left out of report. What meds were left not given or were due at shift change and were not given. And I have to do it fast because the Dr is rounding and will no doubt catch these mistakes and I will be the target of his ire and the face he/she associates with utter incompetence. My shift and I have each other's backs. I will take the heat if my aid forgot to chart or even recheck a temp on a febrile pt. I'm always down to turn/reposition the heavies. And we will answer any call light. That's how we operate, that's our mentality. It is OUR shift and OUR patients. This sense of fellowship or camaraderie was not present when I worked night shift. It was more of an "Us against the world" attitude. Most of them carry some form of chip on their shoulder for the day shift. One reason for this may be because we are generally staffed with more people, but this is only due to the increased work load. Also, recently they implemented a new policy that made night shift responsible for pulling day shifts AM meds (0730-0900) with the exception of any controlled or refrigerated meds and place them in a locked alcove outside of the patients room. This was met with great resistance from both shifts. Nights, obviously, didn't want to have to do it, but the day shift didn't trust night shift to do it correctly and would rather have the extra workload. Admin countered by adding that Day shift must pull night's meds as well from the same time frame. That was met with more resistance. It now stands, at least in policy, not necessarily in practice, that nights pulls AM meds and Days doesn't pull Night's meds. As either a subconscious or passive aggressive form of rebellion it seems that our meds in the AM are almost always wrong. A few nurses absolutely protest doing this.

Most recently, yesterday in fact, I came in for report on 4 repeat patients from the day before and 2 new patients. I noticed in report that one of the repeat patients IV fluids had been stopped and saline locked. Knowing damn good and well that they didn't call the Dr to DC the fluids I asked why the patient was saline locked. I was told that while turning the patient another nurse told her that she thought the patient was saline locked on a previous shift she had worked. So, without checking orders, they simply saline locked the patient and left. WITHOUT CHECKING THE ORDER! Who does that? This is a hospital! This is a new day! Things change, orders are made, treatments are adjusted! This and the STATUS QUO dept! PAY ATTENTION! I know it is a small thing. Hey, it was only running maintenance fluids at 40/hr. But what if it were something else? What if it were vitally important. What if we were running 1/2 NS with 40meq of KCL at 125/hr to correct a low potassium level and they had shut it off and the next shift didn't catch it, then they reported that the patient was saline locked and lack luster noc shift accepted it without question. That's 36 hours at 125ml/hr which is 4500 mls with 40 meq per liter that's 180meq of KCL that the patient didn't get. One day they said, I don't know if the Pt is A/O they've been asleep all night. Turns out they weren't asleep they were unresponsive. THERE IS A FUCKING DIFFERENCE BETWEEN ASLEEP AND UNRESPONSIVE!

Last night after giving report to an eye-rolling, teeth-sucking, sighing, sarcastic, bitter nurse, I began to report off to another and I overheard the other saying that she "wasn't even going to go in a room tonight." ARE YOU SHITTING ME! It's like my whole shift of hard work is negated by their shift of laziness.

Again, I am venting, this is about my hospital, and even within my hospital it is primarily only a few nurses that are responsible for all of this rant.

But it can't be just me that is noticing something like this. I'm not just being negative, right? I feel better already having gotten that off my chest.

Thanks for reading,

As always follow me on twitter @MurseWisdom
Also follow @MurseMafia @That1Murse @JustSomeMurse

Kinky, Freaky Nurses

Get into the mind of a nurse and I’d say the majority are kinky, sexually uninhibited, or like to explore sexually… hell they could even be a closet freak and you have no idea.  Why is that?  Well my opinion on the matter is that nurses (and medical professionals in general) deal with death on a regular basis.  We stare death in the face on a regular basis.  Sometimes death wins and sometimes we give a big middle finger to death and save a life.  With all this death floating around, of course we are cognizant of our own mortality.  And with that knowledge comes that fact that we know we only get one trip around this world (unless you believe in reincarnation) and we want to make the most of it.  We take more risks, we drive a little faster, we have freaky, kinky sex.  Maybe you were a freak before you went to nursing school.  Maybe you became a freak while in nursing school.  Maybe it took a few years after you get out… but I truly think that in death we decide to try to live more.  

FYI – Sex is generally a highly pleasurable activity and we want to get the most out of it… and being nurses and having intimate knowledge of anatomy and physiology doesn’t hurt either ;)

The point of this post is if you are questioning why you like kinkier things then you used to blame nursing.  If you are freak already, then at least now you have something to blame it on… If you have kinky thoughts but are afraid to act on them… know that most of the time with nurses you are in mutual company.  So find a slurse or a murse and turn those thoughts into more than thoughts buried in the deep recesses of your mind.

You’d be amazed of the things that nurses at work have talked about doing or offered to do while at work.. Bad slurses ;)  I could talk about it here but it would go from R rated to X rated relatively quickly, LOL

And if you like “vanilla” sex and think you always will, hell at least enjoy it then.   

Agree?  Disagree?  Voice an opinion? Comment?

Follow me on twitter @That1Murse.  Follow my co-blogger, @MurseWisdom

 

BSN vs ADN

There is a lot of heated debate, especially amongst current Nursing students as to which education produces better Nurses.  BSN or ADN?  So, let's discuss shall we?

Let me begin by just stating that I am an ADN grad and have worked my way up from CNA to LPN to RN.

No matter what kind of Nursing student you talk to they will tell you the same thing.  An ADN student will tell you that Hospitals would rather hire an ADN nurse, especially from his or her program than a BSN student from a near-by and therefore "rival" program.  And a BSN student will tell you the same thing.  Here is a funny touch of Irony, BSN programs better prepare nurses for the type of nursing required in a long term care setting and ADN programs train their nurses for Med-Surg type units and it is usually the opposite when it comes to job placement.  ADN will end up in long term skilled type facilities where as the BSN nurses will flock to hospitals.  I have a friend working at a nursing home that is completely run by ADN nurses.  Not a single nurse has gone beyond the two year mark.  Yet, I met a BSN graduate working as a CNA at a hospital because she hadn't passed the NCLEX yet and since she hadn't gone to a bi-level ADN program she wasn't eligible to take the LPN boards. I was an LPN at the time, in clinicals, telling someone with a BSN that I needed her to do this or that. It was so strange.

Let's try using some simple math to get an answer.  I googled the number of credit hours required to obtain a BSN. I wanted a middle of the road number so I picked Oklahoma City University which, geographically speaking, is pretty well in the middle.  They say it takes 124 credit hours for a BSN.  Any arguments? My college requires 72 hours of Nursing credits in order to graduate.  I graduated with 129 credit hours.  That's just how the system works, between prereqs and liberal arts/humanities electives needed in order to apply, I ended up with 5 more hours than is needed to hold a BSN. So, mathematically it seems to be no different.  (By the way I suck at Math)

(I really hope to get a good discussion going from this blog)

I have talked to nurses that are just straight snobs about their BSN and others that have flat out told me it isn't worth shit, I have friends that have gone on to complete their BSN after ADN.  Me personally I believe we are all just nurses. I mean an RN is an RN is an RN, right? If I go on the get my BSN I don't take another NCLEX, same goes for my Master's level nursing... No new NCLEX.  (However, there is a board certifiaction for Nurse Practitioners if I were to go that route)Those of you in BSN programs... your NCLEX is no harder than mine was and, not to brag, but, I'm sure you won't/didn't do much better on it either.  Surely, its not just a matter of initials after your name, right?

So, BSN students get more class time and more Nursing Theory, whereas ADN students spend their time hands-on in clinicals, labs, simulation, etc...  As far as who is the better nurse... I think we can all agree that that is an individual assessment.  My nursing program didn't make me the nurse I am today, but they did provide me with the essential information I needed to overcome the first big obstacle, which was the NCLEX. 

In my personal opinion, it is better to go through a 2 yr bi-level nursing program.  You can start as a CNA when you start the program. After a year you can test for your LPN and start earning LPN wages and gaining real world experience in nursing. Then after two years (hopefully) you can test for your RN and begin making RN wages and building valuable experience.  Then if you must have a BSN or MSN or ARNP after your name, you can continue your education while working and earning a living.  It may take a little longer than if you just went straight through but you won't be new to nursing when you get your MSN or BSN you'll be a seasoned nurse. 

But what do I know? 

As always, thanks for reading.  Share with your friends, coworkers, and fellow students. And comment! Subscribe! Let me know if I'm pissing you off or hitting the nail on the head.

Send me pictures of your study group or friends doing something vaguely nursing and I might feature it on the Blog. Please don't violate HIPAA. 

Follow me @MurseWisdom on twitter

And special thanks to co-author @That1Murse and to @bigwesyall for his continued support


@MurseWisdom

Know Your Role

I think it’s important in nursing and life in general to know your role and know your qualities.  Are you are leader or a follower?  A critical thinker?  Someone who just wants to get by and draw a check?

I think the lack of knowing this beforehand can contribute to nurse burnout and people with Nursing Degrees working in banks or not working at all.  There are some jobs based on your qualities that may not work well for you.  For example, if you are going to work in a nursing home or an inpatient rehab your leadership qualities will probably be for naught.. and from the time I worked there the most critical thinking that I did was making sure I didn’t give Gertrude the medicine for Olive.  (Now I’m not knocking nursing home nursing, just saying that if you are a person that wants to grab life my the balls and drag it down… nursing home nursing…probably not for you)

I’ve always seen myself as a leader.  I think this is why I gravitated toward ER nursing or critical care nursing in general.  I knew that when the shit hits the fan, I would have to potentially take control of a situation.  We’ve worked multiple MIs, multiple GSWs, and this with one doc in the ER.  I’ve had the doc approach me ask me to assess a chest pain and decide if it’s legit or not.  

I think this is also why I’ve decided to pursue my Nurse Practitioner.  I want to be the guy in charge.  I want to be the giver of the orders not the taker of the orders.  But I know that’s a quality of mine.

What I think you should do, it take a few moments assess the type of person that you are and learn what qualities make you up?  It will pay off and hopefully make nursing a more enjoyable experience.

And as always, follow me @That1Murse and my blog co-author @MurseWisdom.  Feel free to post questions, comments, bitches, whines, moans, groans, and complaints.

Special shoutouts: 

            @BigWesYall and his website www.weshelton.com  - Thanks for the link to our blog.

@jorrrrd_ (Jordan) and her class at LCCC.  Thanks for posting a link on your FB group page.  Enjoy the read.

The Last Straw by TMFS786

By far the most asked question I am asked is why would I choose to go from police officer to nurse? It's a legitimate question, because some people have see NYPD blue and think we get to throw people around and why would anyone want to leave that. The truth is a series of events in stories that are way to long to put into one blog. I have been able to isolate what may be the three biggest facets of my decision: 1) the justice system sucks, 2) aspects of the jobs themselves, and 3) specific events that happened as a police officer. Before we go any further I think it should be said that I love being a police officer (I still do it part-time) and the officers are great people. Nothing said should be seen as a reflection of the people wearing the uniform and doing their job.

The justice system is broken. I hear a lot of complaints about the health care system and everything that is wrong with it. Well, it looks like a diamond shinning in the sun compared to the justice system. Health care is flawed and I doubt there is a good way to fix it that will satisfy everyone. The justice system just seems to be screwing over most people involved with it. Health care still essentially does it job. If you are sick, most likely, you will be fixed. Yes, there are tragic stories of insurance companies turning down people that need an operation or procedure. Do I feel for those people, of course I do and it sucks. The difference is those are isolated scenarios that need fixed. The justice system has a systemic infection that can't be corrected easily. The joke is lawyers are to blame and in essence that's not a joke. It is heart breaking to stand in court and the suspect say he is guilty and the judge tell him to reverse his plea, because he may be able to get a better deal. Especially when you have put in back breaking hours and manpower into finding a thief, then you have to go to court and then that happens. Afterwards the family inevitably blames the police even though they know we arrested them. When I take care of a patient they get better or they get worse. I get to see it and I can deal with that, but to have a win taken because a judge doesn't care is just heartbreaking. Defense attorneys are another breed of slime that's hard to deal with on a daily basis. They are doing their jobs…blah, blah, blah. A person that can defend another person who admits to molesting children by trying to insinuate that the police officers were wrong is pretty disgusting. Imagine a person that just stood in a room and every time you went to start an IV moved the persons arm.

People hate cops. It's a fact of life any police officer will likely tell you depending on how much complaining he wants to deal with after they are honest. People want us out busting crime, enforcing traffic laws and making society safe. That is until we start asking them questions then we are nothing but worthless and harassing someone. It always has to be that they are black or a woman or they drive an expensive car. Nobody has ever said “I realize you stopped me because I match the description of the person robbing houses and I happened to drop my wallet in their house” or “I know I was in the wrong going fifteen miles over the speed limit.” In the end it's always our fault that they did something wrong. A nurse is seen as something in society that represents what people aspire to be. We are trusted and thought of as capable by the public. I want to do my job and do it the best as I can without people hating me for doing it. Another officer and I responded to a child drowning. It was at a house party and accidents happen. The officer and I arrived to find the girl and began doing life saving measures and actually got the young lady to begin breathing again even it wasn't pretty. The party however never stopped and I yelled for the music to be turned down and people to step back, because silly me I wanted to let EMS know what was going on and to have room to work. After the incident several family members came up to me and demanded an apology. I wasn't expecting a thank you, but I certainly didn't see this coming. They said it was obvious since I was the only white person there that the reason I yelled for the music to be turned down was because it was rap music and I was racist. It never occurred to them I guess that I wanted to relay information to the paramedics who were on their way to get the daughter. That was a hell of a way to end that call. The other day, working as a nurse, a parent thanked me profusely for saving their kids life, even after I told them repeatedly that I only helped and I really didn't do that much. That everyone else around me had done much more. It's hard to argue with an appreciative mother with tears in her eyes. That is another reason to leave being a cop and become a nurse. Not only was I thanked, but I was thanked for just being there.

I have been in way worse situations as a police officer then I will ever be as a nurse. That doesn't mean there isn't stress, there is a ton of stress as a nurse, but it's not the same in the field when you are involved in the action. One of the boring but safe reasons for being a nurse over a cop is there is dramatic drop in the safety of being at work. Never has a room burst into flames while passing meds. Nobody has pulled a gun on me while adjusting them in bed. I have seen a lot of things that have made me different than I was before them. Some things can not be unseen or changed in your memory no matter what you do. Trust me I tried and tried. I don't know how I became so unlucky but I had a habit of being at the wrong place, at the wrong time, a lot as a police officer. Over time these incidents wore on me and they still place a weight on my shoulders. It is expected and it hasn't inhibited me in any real sense of measure. A lot of times I am asked essentially “what straw broke the camel's back?” A story that I will keep brief and I have been told may be too graphic for many is the answer. A structure fire was reported and then it was dispatched that children may be in the house. If I had drove to that house any faster I would have went back in time. I had been in some tough situations before, but anything involving kids always seems to hit harder. The house was hot…real hot when we arrived and I knew it was going to be bad. The flames had busted out the front and sides of the house and were extending pretty far into the air. It's something I don't know if I can explain with a thermometer but looked like something out of a movie. I just didn't think it could be real. Eventually we were able to get one child out of the house and into the hands of paramedics who took the child away. One was still reported in the house. I screamed and inhaled black smoke at an alarming rate something I am sure my lungs will repay me for in the future. In the end we got the other one out but it wasn't enough. At the hospital helping the coroner, I saw all the nurses standing there. They were upset but they had done everything possible to help both children which was way more than I had felt I had done. I was envious of the feeling of being able to help and I wanted to feel it more than anything else I could imagine. Hopelessness is the absolute worst feeling in the world. So I made the decision pretty much right then and there. As nurses we affect lives directly and indirectly and we do so from the moment we clock in till the moment we clock out. I am proud to be a police officer and I would never trade this time for anything, but I look forward to the time spent helping others and maybe someday someone will remember that one murse that helped them.

Dealing with Grouchy Nurses

So several people have requested that I write about how to deal with grouchy nurses… and some of this is not going to be cheerful news.  First things first, you are going to deal with bitchy people in any profession… There are bitches in nursing, bitch doctors, bitch lawyers, bitch mechanics… hell even bitches in the Burger King.  The idea is to learn how to handle the situation appropriately so that you remain sane and don’t become the bitch yourself. 

If you are a nursing student and the nurses on the floor are being grouchy… sorry but it’s best to keep your mouth shut, keep your head down and survive the day.  If you butt heads with a nurse on the floor as a student… you will lose every time.  Every clinical day should be a job interview because you never know if you will be colleagues with these people and if you snap on the floor you will get blackballed in that department… hell maybe even the whole facility.

If you are a new nurse, you need to do a few things to deal with the grouches.

• ·         Realize that nurses eat their young.. It’s not pleasant but it’s true.  Put yourself in their position. As they get older or grouchy, they figure their days are going to be numbered.. so to them they see you as the replacement (and they have to train you). In their clouded sense of judgment, if they run you off they won’t be replaced.

• ·         Learn how to deal with that specific grouch. 

o   Some of them are dealing with problems at home or general unhappiness.  If that’s the case either it will get better eventually or they will stay a grouch and you either try to friend them.. or avoid them.

o   Some may be grouchy, but only at work.  These are those grouches that are horrible to work with, but when you go hang out away from work they are fun, relaxed, and a joy to be around.  These nurses typically have been “the bitch” for so long they feel obligated to live up to that role.  Nurse Ratched is a bitch… but Becky is fun to hang out with.  Once you figure out this type, the grouchiness at work won’t bother you near as much.

o   Last common type is those nurses that are trying to push your buttons.  They want to push you to see how far you’ll go and to test you.  My dealing with this type of grouch was about 3 months into my time of working there.  I worked the night shift and this nurse came in and without asking about my night she immediately started complaining about me not stocking.  Finally being pushed far enough, I stood up and yelled that if she’d like I’d stay after my fucking shift and stock the ER.  From the point that I stood up to her, we never had another problem.  She wanted to push me to see if I would stand up to it and once I did, we were fine.

• ·         Don’t take it personal.  Do you think they woke up and said.. hmmm I’m gonna be a bitch to Debbie today?   If that’s happening or you’re thinking it’s happening, then those issues go deeper than this blog.  Don’t let their shitty attitude get you down.  There is enough stuff in nursing that can get you down, depressed, or become cynical… don’t let one shitty attitude be the downfall to your day. 

·         Find the positives in your day.  The patient smile, the thank you’s, the pimpin murse, the slurse that you can tell is wearing a thong, the free drink in the cafeteria cause the cashier sensed your bad day, getting an IV on the first stick, or realizing…..shit you’re getting paid for this now. 

Couldn’t end this on a negative note and didn’t want you think I hate nursing.  I love it….. there are times it sucks. But the positives far outweigh the negatives.

Lastly, shoutout and huge thanks to @weshelton for featuring our blog on his website, www.weshelton.com, check it out (We are listed on the partners page http://www.weshelton.com/partner/) .  Dude is a multitasking fool… looking over his site, I think he’s doing a little bit of everything.

And as always gotta do a shameless plug.  Follow me @that1murse and my buddy @mursewisdom

@That1Murse

@MurseWisdom the Combat Medic

Before I transitioned to civilian life, and before I became an RN, and Long before I became @MurseWisdom, I was "Doc" the Combat Medic. 

I enlisted prior to 9/11... Hell, I enlisted when Clinton was in office.  I became a Combat Medic and a Practical Nurse in 2001.  I will leave specific details out to maintain anonymity.  I was a assigned to a combat arms unit.  I spent a tour of duty in Operation Iraqi Freedom in 2003, we were the first troops in.  Well, our task force went in on the first day as did the 101st and the 1st Marine Expeditionary Force (MEF).  As a matter of fact, I was assigned to the same task force as Jessica Lynch, if anyone remembers her 15 minutes of fame. 

The purpose of this blog is not to talk about combat, or my personal experiences there.  That's between me and the VA. Suffice it to say I saw my share of the "Shit" and it is wild, terrifying, and surreal. Men died, men were wounded for life, and I know what a man being burned to death smells and sounds like.  My intention here is to talk about the self reliance and the amount of responsibility one has as a Combat Medic in a forward area.

First off it should be understood that almost all decisions made by a Combat Medic has one general purpose and that is to "Preserve the Fighting Strength". Which means to keep 'em healthy enough to fight or send them to someone who can.  We always operated under the "guidance" of a Medical Officer (PA) and a Brigade Surgeon (MD) however they were usually distant and only reachable by radio. (Cell Phones had yet to be widely used by the military at this time)

Let me do some copy and paste work here and provide the Army's description of a Medics duties and then I will compare and contrast.

The Health Care Specialist is primarily responsible for providing emergency medical treatment, limited primary care and health protection and evacuation from a point of injury or illness. Health Care Specialists are often called "combat medics" in the Army, because some Soldiers in this MOS are assigned to deploy with Army combat units, and provide emergency medical treatment directly on the battlefield. Other Heath Care Specialists are assigned to military hospitals and clinics to assist doctors and nurses with the health care needs of patients.

Duties performed by Soldiers in this MOS include:

Administer emergency medical treatment to battlefield casualties.

Assist with outpatient and inpatient care and treatment.

 Interview patients and recording their medical histories.

Take patients' temperature, pulse and blood pressure.  

Prepare blood samples for laboratory analysis.

Keep health records and clinical files up-to-date.

Give shots and medicines to patients.

Prepare patients, operating rooms, equipment and supplies for surgery.

In addition to all of that listed above I also had to know how to be a diesel mechanic to fix my Humvee and to fix generators if needed. I also had to be an expert on indigenous wildlife, including venomous arthropods and snakes.  And specifically for my mission, I was the team "Wheeler and Dealer" trading medical goods for supplies/services to help with the mission.  I was especially good at trading.  I was once able to trade some OTC meds for a case of Starbuck's Carmel Frappachinos which made me a hero amongst the 11 other men in my team. 

I have performed minor surgeries, however minor they may have been it still involved local anesthesia in the form of a total nerve block, along with the cutting and stitching involved.  Yes, I did stitches, staples, & I prescribed meds.  All of those things well beyond my scope of practice.  I would on occasion have the opportunity to call in Dustoff, but most of my Evacs were by ground. I assisted in the inoculation of some 10,000 troops with Anthrax and Small Pox vaccines.  I was doing all of this without the supervision of my Medical Officer and all at the age of 20, and without ever losing a pt under my care. 

Now, here I am, almost 30, and I have to call a doctor to get an order for a band aid to treat a <1cm skin tear.  And I've had more training than I ever had as a Medic.  It is frustrating to me that we have achieved so much throughout nursing school and so much in the last century as a profession and we still have our hands tied.  "Dr Mom" is allowed to do more than we are without a Doctor writing an order. 

Don't get me wrong, I don't want to go back into the Army.  My body is broken down now thanks to the Army and I'm afraid that is a young man's game.  Any of you considering military service after nursing school need to approach it with an open mind.  My service was unique to me and my unit, and does not reflect the everyday mission of nurses in the Army or other branches of service.  However, I currently have a Congressman's card in my wallet who wants me to call him about serving in the National Guard, apparently he is also a Colonel or General or something.  Don't hold you breath, pal!

I am interested in working for the VA or the DHHS.  Hell, I would love to work for the CDC or FEMA, but those are dream jobs...  The VA is attainable and I may try that in the near future.

If you have any comments, please feel free to leave them.  Questions can be emailed to Mursewisdom@gmail.com be sure to follow me on twitter @MurseWisdom.

I would also like to give a special thank you to Wes Helton, @BigWesYall for plugging us on his website www.weshelton.com Go check out his website, I think he sells edible clothing, which is always good to have in the event of an emergency.  It may prevent starvation.

@MurseWisdom